血清25羟基维生素D水平与肝硬化合并细菌性腹膜炎发病及进展的关系  

The relationship between serum 25-hydroxyvitamin D level and onset and progression of patients with cirrhosis combined with bacterial peritonitis

作　　者：李冰瑶 安娜[1] LI Bing-yao;AN Na(Department of Laboratory Medicine,Mianyang Central Hospital,Mianyang 621000,China)

机构地区：[1]四川省绵阳市中心医院检验科,四川绵阳621000

出　　处：《实用医院临床杂志》2021年第3期175-178,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨血清25羟基维生素D[25(OH)D]水平与肝硬化并发自发性细菌性腹膜炎(SBP)发病及进展的相关性。方法我院收治的肝硬化腹水患者95例,根据患者是否并发SBP分为SBP组(n=46)和非SBP组(n=49),比较两组一般临床资料、实验室指标和血清25(OH)D水平,分析影响肝硬化腹水患者并发SBP的危险因素;比较SBP组中不同预后患者不同时间点的血清25(OH)D水平。结果SBP组腹水持续时间长于非SBP组,肝性脑病、消化道出血发生率和终末期肝病模型(MELD)评分均高于非SBP组,血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、降钙素原(PCT)、C-反应蛋白(CRP)、外周血白细胞计数、25(OH)D缺乏率、腹水白细胞计数、总蛋白和白蛋白水平均高于非SBP组(P<0.05);腹水持续时间、PCT、CRP、25(OH)D缺乏和腹水白细胞计数是影响肝硬化患者并发SBP的独立危险因素(P<0.05);SBP组29例存活,17例死亡,存活组入院后第3、7 d的血清25(OH)D水平均高于死亡组(P<0.05),两组内不同时间血清25(OH)D水平比较,差异无统计学意义(P>0.05)。结论肝硬化并发SBP患者存在血清25(OH)D水平下降的情况,血清25(OH)D水平与SBP的发病及进展存在一定关联性,临床或可通过补充维生素D水平提高患者免疫力,以改善临床症状。Objective To explore the correlation between serum 25-hydroxyvitamin D[25(OH)D]level and the onset and the progression of patients with cirrhosis combined with spontaneous bacterial peritonitis(SBP).Methods A retrospective analysis was performed on 95 patients with cirrhosis and ascites who were admitted to our hospital.According to presence or absence of SBP,they were divided into SBP group(n=46)and non-SBP group(n=49).The general clinical data,laboratory indexes and serum 25(OH)D levels were compared.The risk factors of SBP in the patients were analyzed by using multivariate logistic regression analysis.The level of serum 25(OH)D among patients with different prognosis in the SBP group at different time points was compared.Results The duration of ascites in the SBP group was longer than that in the non-SBP group.The incidence of hepatic encephalopathy and gastrointestinal hemorrhageand score of model for end-stage liver disease(MELD)in the SBP group were all higher than those in the non-SBP group(P<0.05).The levels of serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),procalcitonin(PCT),C-reactive protein(CRP),white blood cell count in peripheral blood,deficiency rate of 25(OH)D,white blood cell count in ascites,total protein and albumin in the SBP group were higher than those in the non-SBP group(P<0.05).The results of logistic regression analysis showed that duration of ascites,PCT,CRP,25(OH)D deficiency and white blood cell count in ascites were independent risk factors for SBP in cirrhosis patients(P<0.05).In the SBP group,there were 29 cases survived and 17 cases died.The level of serum 25(OH)D in the survival subgroup was higher than that in the death subgroup after 3 and 7daysof admission(P<0.05).There was no significant difference in level of serum 25(OH)D at different times in either group(P>0.05).Conclusion The level of serum 25(OH)D is decreased in patients with cirrhosis and SBP.There is certain correlation between serum 25(OH)D levels and the onset and the

关 键 词：肝硬化 自发性细菌性腹膜炎 25羟基维生素D 危险因素 相关性 

分 类 号：R575.2[医药卫生—消化系统]